Illinois law violating conscience rights could cost it federal funding

The Trump administration has informed Illinois that it could lose federal funding due to a state law requiring health care workers to refer patients for abortions, in violation of federal conscience protections.

Key Takeaways:

• The Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services (HHS) sent a letter to Illinois legislators saying the Illinois Health Care Right of Conscience Act (HCRCA) violates federal conscience protections.

• Illinois' HCRCA required all health care workers and pregnancy resource centers (PRCs) to “inform patients about all available medical options, including abortion and contraception,” tell patients about the so-called "benefits" of abortion (though this specific provision has been blocked), and make abortion referrals.

• The OCR pointed out in detail how Illinois' law violates both the Weldon and Coats-Snowe federal Amendments.

The Details:

The OCR sent a letter to Illinois Governor JB Pritzker, Attorney General Kwame Raoul, and Secretary of the Illinois Department of Financial and Professional Regulation Mario Treto, notifying the officials that the HCRCA violates federal conscience rights. The Coats-Snowe and Weldon Amendments bar the giving and receiving of federal funding if conscience rights for health care providers in relation to abortion are being ignored.

The letter, which goes into great detail, states:

Based on the plain language of the Weldon and Coats-Snowe Amendments, Illinois is prohibited from discriminating against a health care entity on the basis that the entity does not “refer for abortions” or “make arrangements for” abortion or referral for abortion....

Under the Weldon Amendment, the Department is obligated to ensure funds appropriated under the LHHS Appropriations Laws are not used to support a state or local government that subjects “any . . . health care entity to discrimination on the basis that the health care entity does not . . . refer for abortions.”

Similarly, under the Coats-Snowe Amendment, a state or local government receiving Federal financial assistance has a duty to refrain from subjecting “any health care entity to discrimination on the basis that . . . the entity refuses to . . . provide referrals . . . for abortion . . . [or] make arrangements for [abortion or referrals for abortion]....

While the statute provides an option as to which of three requirements a conscientious objector shall adopt to satisfy the protocol requirement, each requirement conflicts on its face with both the Weldon Amendment and the Coats-Snowe Amendment....

Because Illinois accepts funds from HHS that are subject to these laws, Illinois is barred from impermissibly conditioning a benefit, namely, the liability shield available in the HCRCA, on whether the health care entity will refer for abortions. 

“We recognize that faith-based organizations are the first and sometimes the only source of quality care and support services in a community,” OCR Director Paula Stannard said, according to the Washington Post. “We are committed to work to ensure ... they’re not penalized by such programs for their religious beliefs or moral convictions.”

Additionally, Stannard said the OCR is monitoring complaints in two other states, two hospitals, and a health system in Michigan, all for violating federal health care conscience rights.

“We are going to be aggressively investigating complaints; we’ll be vigorously conducting compliance reviews across the board,” she said.

The Washington Post complained that the Trump administration is "willing to use federal funding as a cudgel to advance its priorities," yet failed to mention that the Department of Health and Human Services under the Biden administration withheld money from pro-life states like Tennessee, specifically because they would not refer for abortions. This is the exact same behavior the Washington Post is now flagging as problematic.

The Backstory:

Illinois passed two amendments to the HCRCA in 2016, requiring health care providers to discuss the "benefits" of abortion and refer women to abortionists upon request. No conscience protections were included in the amendments, meaning pro-life providers would face the choice of either violating state law or violating their consciences. This would include pregnancy resource centers (PRCs), which offer pro-life alternatives to abortion.

After the two amendments were put into place, legal battles quickly began. The Thomas More Society sued on behalf of Dr. Ronald Schroeder, 1st Way Pregnancy Support Services, and Pregnancy Aid South Suburbs to block both; last year, a judge agreed to block one of the amendments — the one requiring health care providers to discuss the so-called "benefits" of abortion.

This means pro-life providers could still be forced to make referrals for abortion, violating their conscience rights, which are protected by federal law.

The Bottom Line:

A spokesperson for Pritzker did not give any indication of how Illinois will respond, other than to say that the governor is reviewing the letter and will respond later.